Seven pediatric keratoconus eyes (6 males, 1 female; 12–19 years) previously treated with corneal cross-linking were included. Mean preoperative Kmax was 56.4 D (51.6–64.9), decreasing to 51.4 D postoperatively, with reductions up to −9.4 D. Corrected visual acuity improved in all cases with tomographic regularization. Mean preoperative pachymetry was 445 ± 37 µm (398–503). All customized CAIRS implantations were performed using femtosecond-assisted tunnel creation under topical anesthesia with anesthesiologist-assisted sedation. No intra- or postoperative complications or explantations occurred.
Allogenic Intrastromal Ring Segments (Cairs) In Pediatric Keratoconus : Safety And Visual Outcomes
Published 2026 - 44th Congress of the ESCRS
Reference: POCOR353 | Type: Free paper | DOI: 10.82333/c6ny-hn73
Authors: Dr Carlos H. Gordillo* 1
1CORNEA,ZALDIVAR INSTITUTE,Mendoza,Argentina
Purpose
To evaluate the safety, feasibility, and early clinical outcomes of allogenic intrastromal ring segments (CAIRS) implantation in pediatric keratoconus previously treated with corneal cross-linking (≥12 months prior), focusing on visual and refractive improvement, corneal regularization, and topographic stability.
Setting
Cornea Department, Zaldivar Institute, Mendoza, Argentina
Methods
A retrospective case series of pediatric keratoconus patients previously treated with corneal cross-linking at least 3 months before surgery was analyzed. All eyes underwent implantation of pre-cut CAIRS prepared from donor corneal tissue at the eye bank. Surgical planning was individualized for each case based on preoperative tomography, K values, pachymetric, and refractive data. Segment thickness, arc length, implantation axis, and stromal depth were customized accordingly. In all cases, intrastromal channels were created using a femtosecond laser platform, with depth and centration tailored to each cornea. Postoperative outcomes included UDVA, CDVA, pachymetry, topography , and intra- or postoperative complications.
Results
Conclusions
Customized femtosecond assisted implantation of pre-cut allogenic intrastromal ring segments in pediatric keratoconus previously stabilized with cross-linking demonstrated significant corneal flattening in highly steep corneas, the technique shows safety and no complications were observed. The use of femtosecond guided, individualized planning supports the reproducibility of the technique in young patients. As an additive, tissue-based approach, this strategy may provide early visual rehabilitation in pediatric patients, with the potential to reduce amblyopia risk and delay or avoid the need for corneal transplantation.